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Treatment of thrombotic complications in patients with MPN

By Jen Wyatt Green

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Nov 29, 2024

Learning objective: After reading this article, learners will be able to cite a new clinical development in myeloproliferative neoplasms.


Thrombotic events represent the most significant complications in patients with MPN, with a primary treatment goal of reducing their frequency and reccurrence.1 In current clinical practice, patients with either a history of thrombosis or aged 60 years are classed as high thrombotic risk and managed with cytoreductive treatment.1 More precise thrombotic risk evaluation may be feasible using other factors, such as the presence of a high (>1%) JAK2V617F allele burden.1 

 

A recent review by Guy et al., published in Blood, incorporates case-based discussions and explores optimal antithrombotic treatment types and therapy duration for thrombotic complications in patients with MPN, with a focus on oral anticoagulants and SVT management.1 

Key learnings
Cytoreductive and anti-thrombotic agents are complementary for thrombotic risk reduction. Long-term anti-thrombotic strategies should be tailored to the initial thrombosis type, MPN subtype, and bleeding risk. 
Antiplatelet therapy or revascularization may be required, with indefinite low-dose aspirin recommended following initial therapy after some thrombotic events. 
Regular re-evaluation of the risk/benefit balance of continued antithrombotic treatment in MPN patients treated with anticoagulants is important for improving patient outcomes. 
Patients with MPN and thrombosis should be cared for in multidisciplinary settings to ensure the provision of optimal individualized treatment strategies. 

Abbreviations: MPN, myeloproliferative neoplasms; SVT, splanchnic vein thrombosis. 

References

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